Harnessing Your Health: Addressing pelvic floor issues after childbirth

Your pelvic health probably isn’t something you find coming up in casual conversation. But doctors want you to know it is important, especially after having a baby. The problem is many women don’t know where to start.

So that’s why we’re doing the research for you so you can focus on harnessing your health.

A new survey from Orlando Health shows that the warning signs of poor pelvic health are often brushed off by patients. Seventy percent of Americans agree that it’s normal for women to have some urinary leakage after having kids. That’s when little pressures can make you pee a little. Fifty-one percent believe it’s normal for women to experience pain during sex after they’ve recovered from childbirth.

But these are all signs of pelvic organ prolapse . That’s when the muscles and tissues of the pelvic floor weaken. It’s not something that always requires surgery but health professionals say it should be addressed.

There are two people we’ll be introducing you to in this story to help explain why.

Tessa Ladd who’s an occupational therapist at Orlando Health, and Nicole Lukens who’s a mom of two that decided to seek out pelvic floor therapy .

Here’s her story.

“So I have two children— I have a 5-year-old and I didn't have any issues after the 5-year-old that I was aware of. But then I had my son Cohen, who is one. I would say it was really about three weeks postpartum is when I started to feel a little different," Lukens said. "I remember driving in the car and I was like, something doesn't feel right. It feels super heavy, it was very distinct. So when I got home I just took a look, and I knew it wasn't right."

"I called my OB and they said go to the hospital. So it wasn't like super painful, it was just heavy, and then obviously you know when something's just not right with your body,” Lukens said.

Ladd explains what the pelvic floor does and why it was smart for Lukens to get help.

“So the pelvic floor is a series of muscles and soft tissues and ligaments, and they line the bottom of your pelvic bowl essentially. So they have three main jobs. The first job is to help with bowel and bladder function; so to prevent leaking. Another job is to support the internal organs like the uterus, bladder, rectum. And then the third job, there's a role in intimacy,” Ladd said.

Patients may undergo vaginal or laparoscopic surgery to address pelvic organ prolapse. Laparoscopic surgery is when doctors make just a small keyhole cut. Other operations involve doctors stitching pelvic organs back into place or using a material to support existing tissues and make them stronger.

Recovery time for this can be anywhere between one and six weeks, depending on how invasive the surgery needs to be. Post-surgery, patients shouldn’t do any heavy lifting so the stitches don’t rip.

For our patient Nicole, that just wasn’t an option.

“As a new mom you're lifting a car seat, you're lifting a stroller, and you're lifting a baby. It's impossible, right?," Lukens said. “I was just going on maternity leave. So you get, I get, 3 months with my child and I didn't want anything to interrupt that time.”

So she turned to pelvic floor therapy. Here’s what that involves.

“So some sessions were done, you know, in our private space in my room if we needed to do any kind of manual therapy that required some privacy," Ladd said. "Then sometimes we were out in the gym. Sometimes we were working with weights. I'd have her bring her child in. We would practice carrying the baby in the baby carrier, making sure the fit was right and that we were managing our body, making sure that we were using good body mechanics with her exercises. We did a lot of deep core strengthening, and we also did a lot of bridge work to help strengthen the glutes and hamstrings, which all of those things work together to help support the pelvic floor.”

“It's a lot of like that diaphragm breathing." Lukens said. "So every time I go to pick up, without question the car seat, I hold my breath. And I have to tell myself take a step back, pick it up, breathe out, you know. So every day I do it, and I can feel the difference. I feel so much better. I feel like I've improved so much.”

The survey data at the beginning of this story indicates Lukens is not the only person going through this. In fact, the National Institutes of Health estimates up to 50% of women will develop pelvic organ prolapse over their lifetime.

“A lot of my friends and I, we giggled about it, you know, like you do a jumping jack, you sneeze, you might have some issues there,” Lukens said.

We’ve mentioned some symptoms of pelvic organ prolapse , like urinary leakage, throughout this story.
But here’s a full list of what to look out for:

· Pelvic pain
· Bulging
· Not being able to fully empty your bladder
· Pain with sex
· Lower back pain
· Pressure or heaviness in the lower abdomen area

Aside from childbirth, Ladd said pelvic organ prolapse can also happen because of an injury or poor body mechanics when lifting heavy things.

“And what I would just say is like, be your own resource. Be your own advocate with your health. If you're not comfortable with something like there, there is somebody out there that will fix it,” Lukens said.

Both Ladd and Lukens recommend talking with your doctor as a first step to addressing pelvic floor issues. There are also links included throughout this article that will take you to additional resources.